Endoscopic Mucosal and Submucosal Cutting in benign esophageal stricture: Gut | July 2026

Introduction:

Long benign esophageal strictures remain one of the most difficult benign conditions to manage. Although endoscopic dilation and incision techniques provide temporary relief, recurrence is common, often requiring repeated interventions. This study introduces a novel endoscopic approach designed to achieve more durable stricture release.

Why was this technique needed?

Conventional balloon dilation and radial incision frequently result in restenosis, especially in long, complex strictures. There is a need for a technique that provides more complete scar release while minimizing repeated procedures.

What did the study show?

• The technique combines methylene blue-guided visualization of scar tissue with longitudinal mucosal and submucosal cutting down to the muscularis propria, followed by triamcinolone injection.
• Eleven patients with long benign esophageal strictures underwent the procedure, with eight receiving it as primary treatment.
• Short-term clinical success was achieved in nearly all patients.
• Only one patient required repeat treatment during follow-up.
• The technique appeared feasible and safe, with encouraging outcomes over a mean follow-up of approximately 11 months.

Clinical Impact:

This novel endoscopic approach offers a promising alternative for patients with long or refractory benign esophageal strictures, particularly when conventional dilation or incision techniques have failed. Larger prospective studies are needed to confirm long-term efficacy and safety.

Take-Home Message:

Endoscopic mucosal and submucosal cutting represents an innovative third-space endoscopic technique that may provide more durable relief for long benign esophageal strictures, potentially reducing recurrence and the need for repeated endoscopic interventions.